Provider Demographics
NPI:1477652808
Name:MYERS, JAMES D (PHD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:MYERS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML 5021
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3039
Mailing Address - Country:US
Mailing Address - Phone:513-636-4225
Mailing Address - Fax:513-636-2511
Practice Address - Street 1:796 CINCINNATI BATAVIA PIKE
Practice Address - Street 2:ML 6006
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245
Practice Address - Country:US
Practice Address - Phone:513-636-6000
Practice Address - Fax:513-636-6007
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5500103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist